Provider Demographics
NPI:1992102925
Name:LION MEDICAL, PC
Entity type:Organization
Organization Name:LION MEDICAL, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUTHORIZED OFFICIAL
Authorized Official - Prefix:DR
Authorized Official - First Name:SIMON
Authorized Official - Middle Name:
Authorized Official - Last Name:LEE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:917-345-8840
Mailing Address - Street 1:2 BEL AIR CT
Mailing Address - Street 2:
Mailing Address - City:MILLTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:08850-2183
Mailing Address - Country:US
Mailing Address - Phone:917-345-8840
Mailing Address - Fax:
Practice Address - Street 1:81 ELIZABETH ST
Practice Address - Street 2:SUITE 602
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10013-4729
Practice Address - Country:US
Practice Address - Phone:212-219-9262
Practice Address - Fax:212-219-9263
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-11-19
Last Update Date:2014-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY209983225400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation PractitionerGroup - Single Specialty